“Vassal State: How America runs Britain” by Angus Hanton, Swift London 2024 £25.00 Hardback.
Review by Roger Steer
The book is the result of a quest by the researcher and author to answer the question: how much of the UK is owned by the USA?
The answer is difficult to answer (the UK government does not keep statistics), but it is possible to piece together because the US government and European governments do.
The purpose is not to reject American values and democracy, which helped us fight two world wars and keep the peace (mostly, in the UK that is) but to act as
“a call to action to stop further transfers of parts of the economy to powerful and unaccountable American owners and to reset Britain on a course for more economic independence”
Hanton points out the dominance of US business in public discourse. When we talk about “big tech” we mean “US tech”. When we talk about private equity we mainly mean US private equity. When we talk about multinationals, it’s in the main US multinationals.
Plus, when we talk about the ‘special relationship’ and partnership he asks ”What sort of partnership is it with the mightiest superpower in history, which holds an overwhelming stake in the UK economy?”
It is a paradox that having rejected the EU as a strategic partner in the name of ‘taking back control’ the UK has willingly foregone control over vast swathes of the UK economy. It is unusual for countries to allow such penetration of their home markets to a single country, located thousands of miles away.
In table 1 of the book, he compares figures about the sales of US multinationals in the UK and other leading European countries. It’s 25% in the UK but only 5-9% in Italy, Spain, France and Germany. The net result is a significant amount of profit is extracted, and repatriated to the US, and tax is routinely avoided on these sales. 1,256 multinationals with sales of over $850m operated in the UK in 2020.
It’s a further paradox that the US itself will oppose other countries buying and owning strategic industries, whereas the UK government has seemingly willingly presided over the sell-off of the UK economy. Ex-Chancellors and prime ministers earn good money by facilitating this according to the book.
When even Joe Biden endorsed putting America First the possible consequences of a further Trump Presidency must surely call for a re-think.
How does this affect the NHS?
This question is answered in a Chapter entitled “the NHS Cash Cow”. It covers how US multinationals maneuvered to obtain the vast majority of Covid funding for its vaccines when cheaper UK vaccines could have been used.
Half of all Covid contracts went to US companies. The contract for PPE storage was given to a US company in 2018 and was sold in April 2020.
According to the sources quoted in the book however, it was not just around Covid that NHS reliance on US suppliers became evident. Tony Blair’s Labour Government started outsourcing elective procedures in 2002 and the aim, according to the book was to increase private provision to up to 40% of operations. The book states that US companies have obtained the lion’s share of these new and existing contracts for this work.
Three of the biggest UK private hospital operations are US-owned, American suppliers now provide one in seven psychiatric beds, diagnostics supplies come from predominantly US Companies, the major drug companies are predominantly American – as are seven of the top ten medical device companies, including Medtronic, DaVita, GE Healthcare, Stryker, Johnson & Johnson and Cardinal Health.
The US Portman Dental Care organisation owns 350 clinics. In IT, Oracle, Palantir, eMed, Apple, Alphabet, and Amazon are poised to scoop up contracts that can never be removed once the supplier is embedded in the business processes of the NHS.
In the words of Hanton,
“It will be easy for these and other companies to click into the NHS network because it has already been reshaped to fit more neatly with American business models”.
This includes preventative overprescribing of drugs, excessive testing, and excessive intervention according to the ability to pay.
Most worrying is that the new Vaccine Manufacturing and Innovation Centre at Harwell has been sold off to the US medical giant Catalent, which then scrapped the project. Simultaneously the UK signed a ten-year contract with Moderna binding the country to use its mRNA vaccines.
The author suggests changing course and Britain putting trust and resources in the hands of its own people.
As a reflection on this book, although few NHS jobs have been lost to contracting out of services, the longer-term trends (whereby US multinationals have taken over the NHS Supply chain) indicate the predominant direction of NHS ‘reforms’ to come. It’s not as if the direction of travel isn’t plain to see after reading this book.
For those who think this process is inevitable, the author concludes with the words of Jean-Jacques Servan-Shreiber who warned in 1968: “We are witnessing the prelude to our own historical bankruptcy.”
The French responded to that call by integrating with Europe, acting strategically and plotting a path to prosperous economic independence from the US, at the same time as maintaining strong political and military links.
Hanton suggests that the UK faces the same predicament as in France in 1968 and asks what the UK will chose to do?
I suspect a lot more people will have to read this book before the UK government and its citizens make those choices.
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